The burden of community onset MRSA in Australia

Abstract

Introduction Little is known about the health and economic burden of community onset methicillin-resistant Staphylococcus aureus (CO-MRSA) in Australia. However, this information is imperative for developing healthcare policy and planning, for prioritising and directing resources and for implementing evidence-based practice. Methods We have collated data from academic literature and government reports on the numbers of CO-MRSA infections, the proportions of infections occurring at various anatomical sites and indicators of treatment costs and morbidity, such as length of admissions and mortality rates. Direct costs of treating patients, such as the cost of hospitalisation, were calculated as well as indirect costs to society, such as loss of productivity because of morbidity or death. Results We estimated that the national incidence of CO-MRSA infections admitted to hospital was at least 24.8 /100,000 person-years. Of these, the majority were skin and soft tissue infections (21.2 /100,000 person-years), while bloodstream (BSI) and lower respiratory tract infections (LRTI) and incidences of 3.9 and 2.8 /100,000 person-years, respectively. Considerable regional differences in the nature and frequency of infection were identified. Mortality was found to be approximately 1 in 5 patients for BSIs and slightly lower for pneumonia. Conclusions CO-MRSA presents a significant health issue and the costs associated merit attention to support medical decision making. Standardised definitions and regular surveillance of the incidence of CO-MRSA infections are necessary. Surveillance should also capture data on the consequences and treatments required for a better understanding of the cost of CO-MRSA to Australia.